I never thought I’d carry a pager. I had decided against medical school and being a drug dealer long ago. Who else carries a pager? I thought. Who else needs to be reached and told that their specific skills and goods are needed stat?
Most of my pages come in all caps, which adds to the felt urgency of the request. One might read, “pt expired family at bedside.” This means a patient died and there are family members in the room grieving their loss. Then there’s “cardiac arrest,” which means a patient is having a heart attack and may not make it — and if family is present, watching the CPR could be difficult. “family meeting for pt in 9904” means that the medical team is about to meet with next of kin and will probably be giving them bad news. The protocols for death, potential death, grief, loss, and bad news at the South Side hospital where I work all conclude with “Page the chaplain.”
We’ve sometimes been referred to as “God on call,” but the God part isn’t always clear. That said, people in distress do tend to spontaneously ask questions that might be called theological. After a recent “pt transition to comfort care” page, I sat with a self-identified atheist who asked me, “Where is he now?” after we watched his father’s blood pressure and heart rate fade to zeros on the monitors. Before that moment, the son had shared stories about his father and had told me why he, the son, didn’t believe in God — it was the general irrationality of it all — and had marveled at the monitors as a way to measure the presence of life.
“He’s in your memories,” I answered. “And he’s in the spaces where you share stories about him, and in the relationships that he helped you create.” I paused as we looked together at the presence of his father’s body and felt the absence of his father. Mustering all the wisdom from my toes to my graying hairs, I said, “You’ll have to find a new way to love him.” My voice cracked as I said it, but there are no cracks in my belief that what I said was true. We keep loving the people who are gone, and the pain of grief is our adjustment to figuring out how to love them in their new state. As I left, the son gave me a hug and thanked me for staying with him so that he didn’t have to be alone as he watched his father die. Maybe not having to be alone is the God part.
Sometimes I think the patient brings the God part. At one visit, a woman in her 60s from South Shore, one of the neighborhoods my hospital serves, prophetically said, “You should get some Easy Spirit shoes. God told me to tell you that.” She nodded, convinced that she was giving me a divine message. Turns out it was good advice. In my first year on the job, I went through two pairs of walking shoes.
Some of that walking was answering “pt requesting bible” pages. Now, this may seem like the God part showing up, but sometimes a Bible is just a Bible. Or sometimes it is an invitation to sit and hear about marriage troubles, or about this thing their minister said that has been bothering them, or about the ghost that keeps them awake at night by walking up and down the stairs in their house. In these cases, the request for a Bible, divine communication from the past, creates a conversation without my even having to open the book. Often I carry the Bible in and hand it to the patient, who then puts it on the table by the bed. It sits there while we talk about the patient’s various issues. Asking for a Bible is summoning someone to listen.
What counts as a conversation with God is sometimes hard to judge. Once, I came back to the office space I share with the hospital’s nine other chaplains and found a couple of them pondering a page: “pt in 497 wants prayer with chaplain who speaks in tongues.” We looked at each other, a bit stunned. One of us said, “At least we know that the patient is religious.” Another said, “Yes, and she knows what she wants.” We looked up videos of speaking in tongues to see if it was something any of us could even do. I wondered aloud, “Does the patient think that speaking in tongues happens by request?” I called the nurse back and told her that we didn’t have a chaplain who could speak in tongues, but that one of us would come and see the patient anyhow. Ultimately, the patient just wanted to talk about her hospital bills and whether she’d be able to take care of her husband when she was discharged.
And then one day the plague came and chaplains were declared essential workers. Suddenly all the pages were “transition to comfort care 743” or “pt death 992” or “cardiac arrest covid+ pt 1215” or “family in lobby for end of life visit.” Patients were dying, families were grieving, and everyone was alone. Now we had to keep the grieving family members at a distance. We were used to caring for others, but now that care required us to calculate distances and weigh the costs and benefits to getting just a little closer — to be a human with another human in need. And now the spaces we had previously used for talking with families— those rooms where you get bad medical news—were filled not only with grief but also with tears and gasps and exhalations that felt dangerous. Did anyone in this room have the virus? Would grief literally become contagious?
The operator paged me. It was just a callback number — the rare page that meant someone outside of the hospital was trying to get in touch with a chaplain. With no other context, I picked up the phone and dialed the number. The woman on the other end had heard that patients in hospitals were dying alone and she thought it was so horrible. She wondered if she could bring her hunting gear — flannel jacket, hat with earflaps, rubber waders — to the hospital for the chaplains to wear as protection against the virus so that we could go into the COVID patients’ rooms and be with them at the end. Apparently, she’d been hearing about PPE shortages but didn’t quite grasp that flannel and wool didn’t count as such. I politely declined her offer. The image of chaplains in hunting gear made me laugh for days. I was glad I took the page.